I am a 24 yr old male, former military, suffered a back injury during a training mission. Current diagnosis includes "3 bulging discs, 2 where disc matter is protruding inward toward the lumbar and sacral nerve roots. Spondylosis, and Degenerative disc disease in the L4/L5 L5/S1." I had been seeing a pain management specialist (civilian) in lieu of the VA because my primary care physician in the VA didn't believe me, it took him over 3 months to send me for an MRI.

The Pain Management Doctor I visited gave me steroid injections, which decreased the pain radiating into my right leg quite a bit, temporarily. Over the last 8 months I've went through 4 different prescriptions. The least effective was Hydrocodone 5/500, the most effective being Oxycodone 10/325. Only hard part being the withdrawal I'm currently experiencing while I'm giving Physical Therapy a chance. (Starting to think that was a bad idea).

Biggest Complaints are inability to sleep due to not being able to remain stationary for me than a half an hour without pain.Also struggling with not being able to pick up my daughter or do anything around my home that requires bending or awkward positioning.

I find relief in hot showers, and other than that my only resolution is through pain medication. I have an appointment Thursday morning to discuss a pain management contract, which I believe is the VA's way of giving up.

Any guidance would be greatly appreciated, especially in managing my drug dependencies. I purposefully did not request a refill on my last Oxycodone script so I could drop off of it. from 40mg a day to 0mg a day was a tough drop for me though. Tonight marks the end of Day 2.

Welcome to the forum. I am sorry to hear you are suffering. I can definitely relate, though.

I am afraid I do not have any great wisdom for you. I am sure people who know more will be along soon. I will say, though, that you and only you can truly know exactly how you feel. It was wise for you to seek the help of another doctor if the VA was not treating you. Do NOT allow them to just give up on you. I am in a chronic cycle right now with my back issues and though I've been given a plethora of diagnoses, I have yet to be given a well thought out and sustainable treatment plan. That is why I am still pursuing that "just right" doctor. I am blessed to have a PCP who continues to agree to write out my prescriptions (with the knowledge and consent of my PM and any other docs I see) while I continue my search so that I do not have to deal with switching those every time I switch docs and also because I see out of town specialists, so he saves me a long drive to pick up refills. I am strongly considering asking him to just take over my pain management because he seems to be the only one who actually wants to treat the issue.

But, I digress! Regarding the meds... I understand your concern over dependency. Most of us here who take pain medications would prefer not to be taking them. But often it comes down to making some decisions about your priorities. For me, I cannot function without them. I had to choose: be bedridden, unable to walk OR take pain medication and be able to live a little part of my life. Even with the meds I take, I have still lost a HUGE part of the life I used to live. Aside from the few hours I can get to work, I am almost completely home bound. I used to clean my house top to bottom every Saturday. Now I'm lucky to make it through one room in a whole day and that usually puts me on my back in bed for at least a full day afterward. And some things I just cannot do anymore.

Even with my meds, I'm nowhere near pain free. And I certainly don't get a "buzz" or "high" from them. They are all used up on the pain. I hope that someday I will discover a treatment that will fix whatever is wrong with my back so that I can rid myself of the need for medications. I'm confident that if that happens I will be able to stop taking the meds because the pain would not be there. If that happens, I'll tackle it then. But I can't afford to waste the time until then wasting away in bed and not living my life.

Again, that's just me. What I've decided. You have to make decisions for yourself. Weigh it out for you. Is your pain enough that you need the medication? Or do other treatments work instead? If something else works, by all means, go for that! If not, don't deny yourself relief just because of the stigma.

Talk it over with your doctor. He might have some other med options for you too that you would feel better about.Ry

Hello Clever and welcome to CP and I am sorry that you have to be here.

I am pretty new to the site as well. I got your other post on my tread and reading through yours now, you are right we do have alot of simularities.

I dont think that you going on a pain management contract is by no means giving up just trying to make you comfortable until a time they can do something to help you. From what I have read there are many on here that have contracts and alot of them have other options for different treatments.

If I can ask why you think PT is a bad idea? I know from what research I have done excerise is so very important. I know my PT is very painful sometimes. I found that I take a pain meds an hr befor I go and that helps me sometimes with my PT... I am still going 3 times a week except when I am having a really bad day and cant get off the couch.

I totaly understand the sleeping thing I have not had more than 3 to 5 hrs a night in 3 months. The doc did give me some sleeping pills and just uped the dose and last night between my pain meds and sleeping pills I was able to get about 6 hrs in. Have you asked your doctor for something to help you sleep at night?

I have the same prob as you as well with not being able to stay in one position for much more than about 20 mins with out being in incrediable pain. It is very frustrating. On that I am trying to figure that one out myself.

As for your dependencies I really dont have much to offer up on that one as I am just 3 months into by injuries and am trying to get my pain managed so that I can have somewhat of a normal life and function. But I am sure others will chime in with loads of much more useful info. They really are great in here.

I am sorry I dont have more to offer you but I did want to say welcome and let you know you are not alone and there many here that might be able to help.

Maybe it would be better to stay on a low dose of the pain meds until you're a little farther along with your PT. If your muscles get too tight from the pain, you won't get the full benefit of the therapy.

As far as dependence goes, it's pretty much par for the course on any narcotic pain meds. The shorter the half-life, the quicker you can become addicted (e.g., fentanyl has a half-life of only 7 hours & people can become dependent in a matter of a few weeks). The longer acting ones take longer to create a dependence, but they also take result in a longer withdrawal period (usually a month or so, vs. a few days to a week on shorter acting ones). However, you can slow that process down by skipping days. Maybe you could try just taking the pain meds before your PT. Alternatively, you could try muscle relaxants. It's much harder to become dependent on them, but again you need to be careful because overuse can result in atrophy, which would defeat the purpose of PT.

If you can't sleep though, that's really not so good. You said it's from the pain being so bad. It really sounds like you need something to manage the pain better. I'm sure you already know, but there's a lot of probs that can result from not sleeping -- worsening pain, higher bp/hr, change in appetite & all sorts of mind probs from depression to anxiety & so on. It's really important to get your sleep. Maybe a sleeping pill would be enough, but probably you'll need something for the pain at least for a little while.

If you do become dependent, there are a lot of things the docs can do to help. I hurt myself over the weekend & am back up to the maximum dose for a few days, but I was making really good progress thanks to help from a bp medicine (Catapres patch) used for withdrawal symptoms, and an anti-emetic (Promethazine) for the nausea. If you work your way down slowly, it's not too bad. Maybe you could try taking 1/2 a tab for a while if it's too hard going straight to zero.

For me, my goal is to not have to take pain meds every day. I've alternated days in the past, except for every once in a while when I'd take something for 4-5 days in a row during a flare-up, & never experienced much of any withdrawal.

Just wanted to welcome you to the forum. I know you are having a rough time of it, but I'm glad you posted here. It helps to get things off your chest, so to speak.

I wish I had words of wisdom for you, but I don't. I take oxycodone 10/650 for my fibromyalgia and I know I couldn't live without them. It must be hard going off of them cold turkey like that. I wish you luck with your physical therapy. Keep up with that.

I wish you well and urge you to continue to post on here. You will find many caring people here, many of whom can help you with suggestions, much like the ones who have already posted on here with this thread.

I look forward to getting to know you.

Gentle Hugs,

LindalooModerator Chronic Pain

Believe in yourself. Be kind to fellow humans and animals. Take time to smell the flowers and the coffee.

And by all means, when you are down, ask me for help. I will be there.

I haven't been around for a while. My name is Chris in case anyone on the board is wondering or we haven't met.

I just want to say that you will have 'dependencies' on the narcotics, they are what make you function and feel better then you depend on them to function. Just like someone that take blood pressure or heart medicine, they are dependent on them. So don't automatically assume that being dependent on a drug is a bad thing, it helps you come close to the way you were before the pain then its necessary, and if your bad off enough, well well worth it.

Clever,It's very late here in CA - 2:20 am.I'm sorry to hear about your problems. I briefly read your post and from what I gather youare definitely in need of opiod pain medicine thatwill give you some help.Oh dear God, I hope you find the right doctor.You deserve it. I will post more later - not thatI have any wise words. We'll all try. That's whatwe do here.Pamela NeckpainMEDICAL CONDITIONS

Clever,I will just write notes in tiny bits. Writing too long, hurts my back. But I'mthinking about you.What I Know about Pain Contracts: I've never had one but I believe it's agood sign that they want you to sign one, It could mean that they will giveyou the necessary pain meds until they have come up with a better idea. All you have to do is sign your name and agree to not take any more medsthan your prescription reads. I think Pain Contracts are really stupid, but I don't make the rules.As I read your post, you really need special specialists. Work at getting the help youneed. Let us know how you are doing.Pamela will be back later and has more to say. : ) (Good things) Pamela

Hi Clever and welcome to HW. I see a pain mgt dr and he has a Contract that all of his patients must sign. It basically states that he will be the dr in charge of writing all scripts for pain meds, no dr shopping or pill shopping, no sharing your meds with family or friends or obtaining illicit drugs. Also, they like for you to use one pharmacy raather than several different ones.

I am not sure I understand the logic of stopping your meds in order to start physical therapy. I have never heard of that one. If they wanted you off your meds, it would be better to do a slow taper over just stopping. I would think with pain meds & a muscle relaxer it would only add to your PT being perhaps successfull. Oh well, I am not a dr either,lol. Without medication I could not have done some of the things I did while in pain.

Hello Clever and welcome. Sorry to hear you are suffering. I understand how you feel about the meds, I have similar mindset. It isn't good being dependent on medication.... with me , I felt it weakened me....not sure how to make that make sense hehehIt is a very individual thing... you show a strong will there, & that can really work in your favour.At the end of the day, it's your body and your pain...management should be as much your decision as a doctors.Swimming is very good for me...do they do any water therapy there? Everyone has offered sound advice...and it's hard for me, as I live in Australia...our medical is so different to the US... and I have an odd attitude to it all.. pain that is. I think that attitude makes me less than effective in this format....because my opinions are so diverse. But I do empathise, Clever.... and wish you well. Maree

I think that all attitudes are welcomed as sometimes one can find something that they may not have thought of and because you live in Aussy your treatments may be different but open up a door that here in america we havent heard of yet or isnt maybe practiced here in alot of places. So feel free to express, at the end of the day when we stop learning we really have died!

I know me personaly I am up for any suggestions that would help, and you never know unless you try it for your self.

I truly appreciate all the input. I'm at a very frustrating time in my life right now, although compared to some of the threads I've read, I'm blessed to be where I am. I managed my cold turkey withdrawal rather well, it lasted just over a week. I could immediately tell what symptoms pertained that were not related to the withdrawal, and which I continue to suffer from:

Intense Lower Back Pain, several areas prone to spasms (it seems I'm never without one or two visibly raised areas near my spine), and a need to limp to decrease the radiating pain into my right leg. Heat helps, only a little, and not counting the week of withdrawal I've managed no more than 4 hours of sleep a night since I stopped the pain meds. Today I was in so much pain that my physical therapist wouldn't work on me, and after crawling out of my shower (literally) I was unable to dress myself without my wife's help. At 24 yrs old and a former Corporal in the Marine Corps, I can't imagine anything more humiliating than requiring help to get my underwear on. I cried for about an hour this morning, and finally drug myself to the VA Clinic to ask for help, my situation was greeted by a doctor who didn't have the time to even see me, and just wrote me a script for Darvocet and had a nurse bring it to me in the waiting room. (The VA has a contract with Wal-mart so I had to spend an hour sitting on a metal bench waiting for the prescription to be filled.)

Long story short, here I sit, with an ice pack stuffed in my back brace, quickly losing my concern about addiction and just wanting my life back.

I spent three months explaining my symptoms over and over again to the same man before finally receiving an MRI, and when the MRI concluded that my symptoms match (to the letter) the findings of the MRI, this doctor still won't take me seriously. He has the power to fix this, but chooses to dismiss my issues as "bearable" since according to him, being able to limp into his office means I'm functional. I wish he could find a way to explain to my 8 month old daughter when she's sitting there crying on the floor and all daddy can do is look at her until mommy can come pick her up and give her to me, that this is functional in his medical opinion.

I greatly appreciate the input and kind words, but I must admit, I don't know how much longer I can live like this. I really want my life back.

ladyred said...HIf I can ask why you think PT is a bad idea? I know from what research I have done excerise is so very important. I know my PT is very painful sometimes. I found that I take a pain meds an hr befor I go and that helps me sometimes with my PT... I am still going 3 times a week except when I am having a really bad day and cant get off the couch.

Lara

The PT isn't the bad idea, the letting my doctor send me through it without pain management is what I'm concerned about. I don't believe I'm benefiting much from PT since I'm pushing through borderline unbearable pain.

I was wondering if you can go outside of the VA? My dad is a POW and has a great VA, but he has heard many horror stories from fellow POWs that dont and have to seek treatment elsewhere. I would encourage you to look outside the VA if all possible.

Many of us, including myslef have had to go through several doctors before we found one that would treat us or manage us with any kind of diginty or meds. I have been to 4 and Im only 3 months into my accident.

I know you worry about addition, but once again I really want to stess there is a difference between addition and DEPENDANCE, a big differance. You have already proven you are able to get off the pain meds with less diffuctly than others so I would deff assume you dont have an addition problem clever but a dependance that helps you to fuction in a world of pain. It is a dependance out of ness. and not out of want of pain meds.

I can understand completly that you are worried about addition and the stigma that comes with being on pain meds for an extended amount of time. You have nothing to prove to anyone but your self clever and for those that dont understand then you just have to file that away as there problem, they are not the ones dealing with your pain.

I, myslef, can not sleep at night due to my pain in my lower back, hips, and thighs. It is so bad at night I cry every night. I hate pills and I hate pain meds exp. I hate the way they make me feel, but I hate the pain even worse. At night even on the pain meds, I find it almost unbareable. I sit there thinking every night will I finally get up and go the the er this night.

I have to be able to manage my life and right now only having slept 3 to 5 hrs a night for the last 3 months has taken its toll on me and I am warry thin. You have to be able to get some sleep clever. That makes everything even worse to deal with, I know!

I am not an advaget of pills by no means clever, but there are a time and place and sometimes we do what we must to surrive and not what we want.

I would also try ice packs, I swear by them more so than heat but that is me. and Please, Please seek another doctor if at all possible clever there very well could be more help for you. One of the things to check out is RF injections....there radiofrequency ablation injections. I know I will looking into them myself and we have similar problems with our lower backs. The steriod injections have not worked for me so far.

I really hope things get better for you clever and remember you have control over your doctors they are to work for you and not the other way around and if they dont then find one that will. It is your right as a humam being, father, husband and as a former military man!